Monday, 14 May 2012

Mosquitoes and Vaccinations

I was on the bus to Seoul at 7:20am on Saturday morning en
route to get my travel vaccinations. I had already received my Hepatitis A and
Typhoid jabs before coming to Korea but needed a Hepatitis B shot and a Japanese
B Encephalitis shot. I found a clinic in the foreigner friendly area of
Seoul called Itaewon that specialises in travel medicine for expats in Korea
and booked an appointment. I slowly made my way from the
Dong Seoul Bus Terminal across the city on the subway to Itaewon. My
appointment was at 11am and I had some time to kill when I arrived which I
spent walking around listening to my iPod and scouring the shelves of ‘What the
Book’, an English language bookstore in the area.

The clinic was on the fifth floor of a tall apartment
building to the north of Itaewon. It was busy inside and the only customers in the clinic appeared to be foreigners. The receptionists spoke very good English
and took some of my details down. They took my height and my weight and checked
my blood pressure and then proceeded to take me through for a travel
consultation with the doctor. The doctor was a friendly middle aged Korean man
with fluent English and we discussed my requirements. He recommended that I got
the vaccines that I had assumed I would need and also recommended I take some
malaria medication as it is endemic through the entire country of Laos.

The doctor mentioned two malarial medications, Malarone and
Doxycycline. Malarone is expensive but pretty much side effect free and
Doxycycline is cheap but has numerous side effects including sun sensitivity,
headaches and upset stomachs. I asked the price difference and decided to opt
for the more expensive drug. I’d rather not have my holiday thwarted by an
onset of the shits. I'm not at all queasy about needles and I quite enjoy the tension in the air in those few moments before the needle penetrates your skin. One in each arm this time. Lovely. I left the clinic after having my vaccinations and went to
the pharmacy to pick up my malarial prescription.

Arriving home, I realised that the drugs I had been given ‘Lariam’
didn’t match up with what the doctor had been telling me about. I scoured the internet
looking for an explanation but it seemed like that tablets I had been given
were ineffective against mosquitoes in certain areas of Laos that I would be visiting.
I spent my whole weekend worrying about this and came to the following conclusions:

1. Don't take any antimalarial medication and rely on DEET spray, mosquito nets and other preventive measures (long sleeves etc). The other major risk in Laos and indeed much of South East Asia is dengue fever for which there is no medication, it's also transmitted in the same way a malaria so all of these precautions must already be taken to avoid contracting dengue.

2. Take Lariam and hope that I don't get bitten in Bokeo and risk the possible debilitating side effects.

3. Take Lariam and avoid the Bokeo region of Laos.

4. Get Doxycycline and take it for the duraction of the travel and risk the side effects while still taking preventive measures for dengue.I emailed the
clinic to ask what had happened and this morning after much twiddling of
fingers they emailed me back. It appears that the wrong prescription was
written out for me and I had been given the wrong drug. Lariam and Malarone are
two completely separate anti malarial drugs. They told me that when I go to the
clinic to receive my Hepatitis B booster I can get a refund on the Lariam and
pick up the Malarone. Problem solved. Looks like I’ll be taking Malarone, a preferably side effect free drug that is taken 1-2 days before entering Laos, once a week whilst in Laos and for one week after leaving. Perfect. You see how fun it
can be to plan a trip like this?

On Sunday
Nathanael and I went for a hike up the 591 meter Changan Mountain, which was
refreshing. It’s been a long time since I went hiking and it felt good to be
amongst the trees, and the bugs. Spring must be here because the bugs are out
in full force; I even caught a pair of mosquitoes having it away in my
apartment a few nights ago. Unacceptable. After hiking we had some lunch at a
local Korean restaurant and then had a waffle whilst swinging on the swings in
the Sanae school playground. A relaxing Sunday. I watched Game Change in the
evening (the HBO film about Sarah Palin) which was brilliant. School is much
the same as it ever was, we are over half way through the semester now, and
time is starting to escape me.

I’m glad that all
of my travel medicine problems are solved and the only thing left to buy is a
mosquito net for hanging over my bed at night. I’ve booked my flight home from
Germany now so it is finally official that I’ll be arriving back in the UK on
November 17th. So, I guess I’ll see you then. Hopefully I’ll be
disease free. That’s the plan, anyway.